以「五全概念」發展失智照顧技巧課程可行性研究

Dementia Care Program Develop through Wholeness-based Approach

目的：因老化而致失智議題成為各國所面臨之重大議題，本國透過身心障礙者權益法及長期照顧服務法，保障罹患失智症之身心障礙者也應享有適當的長期照顧服務。依據衛福部失智症診療手冊失智症照顧是一件全人、全家、全程、全隊、全社區的照護工作。為滿足失智症病程照護需求，本計畫以發展出「五全概念」為基礎之課程，滿足失智家屬各階段日常照顧需求，並驗證其需求性與可行性。方法：本計畫由失智症照護核心團隊成員組成，課程發展區分為三階段進行：第一階段，組成跨專業焦點團體|第二階段，招募失智家屬或實際照顧失智症之志工20名參與八週課程|第三階段，依據第二階段失智照護師資團隊及家屬回饋，將五全概念結構化後完成課程內容設計。結果：本計畫由失智照護跨專業團隊以及家屬參與共同完成。第一階段焦點團體共發展出：失智症診斷與照護新知及居家護理照顧原則與技巧等八大主題。第二階段，招募失智家屬或實際照顧失智者參與八週課程，出席率達50%以上，每次兩小時者共計14人。女性為主佔80%，其家中自行照顧的比率最高佔83%。第三階段，依據第二階段失智照護師資團隊及家屬回饋，將五全概念結構化後完成課程內容設計，招募20名失智症照顧者或家屬，驗證課程的適切性與需求性。結論：八大主題結合全人、全家、全程、全隊及全社區之五全概念所發展完成課程表，使失智家庭做到證嚴法師靜思語中「生者心安，亡者靈安」之境。本計畫為實務課程內容設計，未來建議可搭配失智照顧者負荷量表或需求量表等結構式問卷收集意見，使課程發展更周延。

Background: The issue of dementia due to aging has become a significant issue faced by various countries. According to the Person with Disabilities Rights and Protection Act and Long-term Care Service Law guarantees that people living with disabilities and dementia deserve access to long-term care services. Dementia Diagnosis and Treatment Manual published by The Ministry of Health and Welfare defined a whole person dementia care, includes the whole family, the whole process, the whole team, and the entire community. In order to meet the needs of dementia care, this study is based on the development of the＂five whole concepts＂curriculum to meet the daily care needs of demented families at various parts of life span and to identify their needs and challenges. Method: The curriculum development is divided into three stages: (1) established an inter-professional focus group| (2) recruited 20 families of dementia patient or voluntary caregivers. Participate in the eight-week course| (3) structure the five whole concepts and complete the course content design based on the feedback from the demented care teacher team and family members in the second stage. Result: In the first stage, health professionals and caregivers jointly developed the program with eight themes including knowledge on the diagnosis and dementia care, home care principles and techniques. In the second stage, 14 (85% female) family members of dementia patient or caregivers were recruited to participate in the 2hours eight-week course, with an attendance rate of more than 50%. 83% of them are home based care. In the third stage, the course content design was revised based on the participants' feedback then re-evaluated by 20 informants to verify the relevance and feasibility of the course. Conclusion: The eight themes combined with the five-total concepts developed by the whole person, the whole family, the whole process, the whole team, and the entire community to develop the program curriculum. This plan is designed for the content of practical courses. Feedbacks were collected through structural questionnaires for future improvement.